Women’s Foot Health

Walking in narrow-fitting shoes or high-heels pose risks for arch and ankle problems in women.



Common issues:

Morton's Neuroma

A thickening of nerve tissue in the ball of the foot resulting from compression and irritation of the nerve, such as from wearing high-heeled shoes that cause the toes to be forced into the toe box.


Bunions

Although both men and women can get bunions, the shoes worn by women sometimes make the deformity get progressively worse.

Heel Pain and Plantar Fasciitis

Although faulty foot structure is the most common cause of plantar fasciitis, in women it may result from wearing non-supportive shoes such as flip-flops and ballet flats.


Ankle Sprain

While anyone can sprain an ankle, women are especially vulnerable to this injury when wearing high-heeled shoes.

CARTIVA® Replacement

  • WHAT IS THE CARTIVA® SCI?

    The Cartiva® Synthetic Cartilage Implant (Cartiva SCI) is a man-made implant that is made of a soft plastic-like substance and salt water. These materials are combined and moulded into a solid, slippery, and durable implant.


  • WHAT IS THE CARTIVA® SCI USED TO TREAT?

    The Cartiva SCI is intended to treat painful arthritis in the joint of the big toe.

  • WHAT YOU NEED TO KNOW

    WHO SHOULD NOT RECEIVE THE CARTIVA® SCI (CONTRAINDICATIONS)?


    Tell your doctor if you think you have an infection in your foot. An infection makes it risky to have the Cartiva SCI.


    Tell your doctor if you think you have ever had any allergy to or reacted to any plastic or an implant. 


    The Cartiva SCI is made from a plastic-like mixture (polyvinyl alcohol and saline). You could be allergic to it. An allergic reaction to the Cartiva SCI might mean you would need more surgery to remove it.


    Tell your doctor if you have a form of arthritis called gout that also causes small lumps (tophi) to form under the skin around your joints. The Cartiva SCI might not work in your joint with this kind of arthritis.


    Tell your doctor if you have any of the following conditions that can hurt implant support. 


    • Cancer
    • Hip dislocation
    • Brittle bones or bones that break easily
    • You have taken a steroid medication in the past
    • You had an organ transplant
    • You have taken an immunosuppressant mediation in the past 
    • You have a history of any growths (tumors) in your bones

    These conditions might lead to changes in your bone that might make the Cartiva SCI device unable to work properly. You should speak to your doctor to determine if the above conditions apply to you, or if other conditions may make the Cartiva SCI not right for you. 

  • HOW HAVE WE TESTED THE CARTIVA SCI® IN CLINICAL TRIALS?

    A controlled clinical study tested the Cartiva SCI. The study happened in hospitals in Canada and the United Kingdom. Patients had osteoarthritis in the joint of their big toe. Study patients received the Cartiva SCI or a fusion of their first joint. 202 patients were treated in this study. 152 patients received the Cartiva SCI implant. 50 patients had fusion surgery. Patients were seen over a two-year period from surgery including a visit two years after surgery. Of the Cartiva patients, 151 patients of the 152 were available for the two year visit and 47 of the 50 fusion patients were available at two years. 


    In the clinical study, 89% of Cartiva SCI patients had significant pain relief two years after treatment, while 98% maintained or improved their function at two years after treatment.

    74% of patients maintained or improved their amount of motion at two years after treatment. 

  • HOW LONG CAN I EXPECT THE CARTIVA SCI® TO LAST?

    The Cartiva SCI device is a long-term treatment for your big toe joint. There have been limited cases where the Cartiva SCI was removed because a patient still had pain in their big toe joint.


  • ARE THERE ALTERNATIVES TO USING THE CARTIVA® SCI?

    Surgery will likely be recommended by your doctor if other non-operative methods have not been successful at reducing your big toe arthritis pain. 

    Other surgical treatment options may include:


    • Cheilectomy: A surgery that involves shaving bone from both the joint surfaces of your big toe

    and removal of the diseased portion of the metatarsal head.

    • Hemi-arthroplasty: A surgery that replaces part of your joint with metal or plastic parts to serve as the new surface of the first metatarsophalangeal head.

    • Total Joint Replacement: A surgery that replaces your joint with metal and plastic parts to replace both sides of the MTP joint.

    • Fusion (arthrodesis): A surgery where the two sides of the MTP joint are cleared of cartilage. The two bones are held together with plates and/or screws so that the bones grow together.

  • WHAT PROBLEMS HAPPENED FROM CARTIVA® SURGERY?

    The Cartiva SCI device study followed 152 patients for 2 years after surgery.


    The most common adverse events were:

    • Pain due to surgical procedure
    • Wound swelling, draining or delayed healing or scarring
    • Joint stiffness or hardening of your joint (induration)
    • Tendon swelling (inflammation)
    • Damage to nearby nerves, arteries, or veins
    • Infection
    • Numbness in toes
    • Changes in the way you walk (gait disturbance)
    • Blood clot formation in one or more of the deep veins in your body (deep vein thrombosis), collection of fluid in the lungs (pulmonary embolism), or blood clot (thrombosis) formation in other vessels
    • Reactions to the drugs or anaesthesia (the medicine they used to put you to sleep) used during and after surgery
    • Heart attack
    • Blood loss, blood vessel damage, swelling of the blood vessel in your leg (phlebitis) or a localized collection of blood outside the blood vessels (hematoma)
    • Additional surgery to remove or replace the implant due to more pain
    • Other operative procedures
    • Pain and discomfort associated with the operative site or presence of implants
    • Joint with excess motion (instability) or at an abnormal angle (malalignment)
    • Swelling or escape of fluid in body cavity (effusion)
    • Fracture of part of your sesamoid or metatarsal bone
    • Progressive osteoarthritis or disease of the joint (arthropathy)
    • Changes to the foot bone
    • Implant may loosen, wear out, or break which may need another operation to remove the implant and may need another method of treatment
    • Sensitivity or allergy to the implant material 
    • Bone loss
    • Poor positioning of the implant
    • Joint or bone irritation
    • Damage to surrounding tissues
    • Other unexpected reactions

Yoga Therapy to Treat Plantar Fasciitis by Kamala

The purpose of yoga is not to do handstands. Nor is it to be able to fold yourself into something resembling a contortionist in a travelling circus act... yoga helps you get unstuck. 


It balances flexibility with strength and allows you to breathe into the tight knots that have grown through years of stress and misuse of your body.  Yoga helps to smoothen the layers of fascia that weaves through your organs, muscle tissues, bones, nerves, and ligaments.


Repetitive strain on the bottom of your feet; resulting from poor choice of footwear, repetitive actions like running on hard surfaces without adequate padding, practising dance forms like ballet, walking, or standing for extended periods on high arched heels can result in the fascia layers being strained and eventually damaged or torn. This is known as plantar fasciitis.

Here are a few exercises that you can try safely to help seal the injury, protect your foot from further strain and gently coax your muscles and fascia to become unstuck and heal.

Staff pose

Sit with your feet against the wall. Flex your feet such that your toes and heels exert the same amount of pressure on the wall. Feel your sitz bones rooting down on the floor, pelvic muscles are contracted, inner thighs are contracted and are pressing in, knees are extended, and quads contracted; imagine you are wearing socks over your knees, visualize pulling those socks up towards your hips. Place your hands on either side of your hips, sit tall, spine is straight and long. Practise shifting the force of the push from your heels to your toes. Be gentle with yourself. If it hurts too much, place a cushion between your feet and the wall and try again. 


Hand to feet pose

Come to standing on your mat with your feet hips distance apart. Check to make sure that your big toe and heel are in one line, perpendicular to the front of the mat. Take a deep breath; reach your arms up and overhead to lengthen through the spine. Pivot from the hips and keeping the length in the upper body, plant your hands under your feet, stepping your toes on open palms with the finger pointing in. Pedal your feet a few times, shifting your weight from one leg to another and using your hands to gently cup the underside of your feet. Practise shifting your weight gently from the balls of your feet to your toes. This gives you extra support through your palms and works to improve your balance by working on shifting stress from your heels to your toes and vice-versa.

Head to knee pose

Just as you did with staff pose, however this time, face away from the wall; sit erect and rooted through your sitz bones with legs extended and quads engaged. Bend your knees and interlace your fingers on the outside of your flexed feet. Then gently begin to straighten your knees away from you, keeping your fingers locked behind the feet. Visualize your torso folding forward and your head touching your knee. Work towards that image. If you do not yet have the shoulder flexibility to keep your hands interlaced outside your feet, you may use yoga straps.


Downward facing dog

Here is another basic yet loaded position. It forms the foundation of any yoga practise. Many who have plantar fasciitis find this excruciatingly painful and cannot bring their heels to touch the mat. Well, here are a few modifications. Ensure that your feet are not too wide or too distant from the medial axis of your hips. Feet should either be touching each other or hips distance apart. Work to press your hands into the mat and your hips to the ceiling, creating space in your lumbar spine and easing the pressure on your hip joints. Next, place a blanket roll underneath your feet to help support your arch and press your feet firmly on the roll. Check to make sure that you are not everting or inverting your feet. The planes of your feet are horizontal with equal pressure distributed from big toe to little. Pedal your feet a few times, bend and straighten your knees are few times – all the while maintaining the muscle engagement and bone alignment of your upper body and hands. Practise rising onto your tiptoes and pressing back onto the blanket roll.

Regards,

Kamala

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